Provider Demographics
NPI:1972012771
Name:OCCUMED HEALTH & WELLNESS, LLC
Entity Type:Organization
Organization Name:OCCUMED HEALTH & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / CRNP
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:334-239-4957
Mailing Address - Street 1:PO BOX 8021
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36110-0021
Mailing Address - Country:US
Mailing Address - Phone:334-239-4957
Mailing Address - Fax:334-593-1702
Practice Address - Street 1:1231 PERRY HILL RD STE C
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36109-5206
Practice Address - Country:US
Practice Address - Phone:334-239-4957
Practice Address - Fax:334-593-1702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-25
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2083P0500X
AL1-117172261QX0100X, 363LX0106X
AL5742363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational MedicineGroup - Single Specialty
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental MedicineGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1720537335OtherINDIVIDUAL NPI NUMBER
5025477818OtherNRCME
AL1598722753OtherINDIVIDUAL NPI NUMBER
AL1-117172OtherANCC-CRNP